Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Prediction of difficult laryngoscopy in emergency care settings is challenging. The preintubation clinical screening tests may not be applied in a large number of emergency intubations due to the patient's clinical condition. The objectives of this study were 1) to determine the utility of sonographic measurements of thickness of the tongue, anterior neck soft tissue at the level of the hyoid bone, and thyrohyoid membrane in distinguishing difficult and easy laryngoscopies and 2) to examine the association between sonographic measurements (thickness of tongue and anterior neck soft tissue) and difficult airway clinical screening tests (modified Mallampati score, thyromental distance, and interincisor gap). ⋯ This pilot study demonstrated that sonographic measurements of anterior neck soft tissue thickness at the level of hyoid bone and thyrohyoid membrane can be used to distinguish difficult and easy laryngoscopies. Clinical screening tests did not correlate with US measurements, and US was able to detect difficult laryngoscopy, indicating the limitations of the conventional screening tests for predicting difficult laryngoscopy.
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Adolescent females are disproportionately affected by sexually transmitted infections (STIs). Although Trichomonas vaginalis (TV) has been declared the most common nonviral STI, TV testing is not routinely conducted in the emergency department (ED), and when it is performed, insensitive testing methods are often used. Therefore, this study sought to determine the prevalence of TV and factors associated with TV infection among symptomatic adolescent females presenting to a pediatric ED. ⋯ A substantial proportion of adolescent females presenting to a pediatric ED with lower abdominal or GU symptoms had TV infection. TV testing should be considered as part of the evaluation of adolescent females presenting to the ED with lower abdominal, urinary, or vaginal complaints.
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Increasing the size of medical school classes has resulted in the use of community hospitals for emergency medicine (EM) clerkships. While differences in clinical experience are expected, it is unclear if they are significant. The authors set out to investigate whether or not clinical site affects student performance on a standard written exam as a measure of medical knowledge. ⋯ This study found no evidence that clerkship site affected final exam score. Academic EM clerkships may consider partnering with other hospitals for clinical experiences without compromising education.
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Multicenter Study
Emergency department presentation of children with tuberculosis.
The objectives were to describe emergency department (ED) presentations of children with tuberculosis (TB) disease and assess the utility in children of TB screening tools developed for adults. ⋯ The point of entry to health care for many children with TB is the ED. The more protean manifestations of TB in children can decrease the utility of screening tools developed to identify adults with TB. While TB in adults often is a microbiologic diagnosis, childhood TB often is an epidemiologic diagnosis. Therefore, questioning caregivers about TB risk factors in the family may identify a higher percentage of children with possible TB.